IEEE Journal of Biomedical and Health Informatics

Major depressive disorder (MDD) is a common psychiatric disorder that requires reliable and objective assessment for early clinical intervention. Electroencephalography (EEG) is widely used for this purpose because it provides a non-invasive and low-cost measure of brain activity with high temporal resolution. However, EEG-based depression detection remains challenging due to the nonlinear nature of EEG signals, inter-subject variability, and the limited availability of subject-independent evaluation. To address these issues, this paper proposes a hybrid quantum-classical multiscale long short-term memory with parameterized quantum circuit branches (MS-LSTM-PQC) framework for subject-level EEG-based depression detection. The proposed model extracts temporal representations at multiple scales using parallel LSTM branches and incorporates eyes-closed (EC) and eyes-open (EO) condition information through condition-aware feature fusion. To further enhance the learned representations, scale-specific LSTM features are processed using PQC-based quantum branches implemented with TensorFlow Quantum (TFQ), providing an additional nonlinear feature transformation before classification. Experiments were conducted on the Mumtaz EEG depression dataset using EC-only, EO-only, and merged EC+EO conditions with 1-s, 2-s, and 3-s EEG windows. To reduce subject-level data leakage, all experiments were evaluated using 5-fold and 10-fold GroupKFold validation. The best overall accuracies across the evaluated settings were 92.05% and 95.08% under 5-fold and 10-fold GroupKFold validation, respectively. The 2-s merged EC+EO setting provided the most stable performance across validation protocols. In addition, Integrated Gradients (IG)-based explainability analysis showed that frontal and fronto-central channels, especially Fz, showed higher contributions to the model decision. These results suggest that multiscale temporal learning with quantum-enhanced feature transformation can support subject-level EEG-based depression detection under leakage-controlled evaluation.

Background: Wearable technologies enable scalable and continuous monitoring of emotional states through passive sensing of physiological and behavioral signals. However, conventional learning approaches often struggle to model the complex temporal, contextual, and relational dependencies underlying human emotions. To address these limitations, we propose a graph-based framework that represents multimodal wearable observations as heterogeneous knowledge graphs enriched with semantic information derived from Large Language Models (LLMs), enabling richer contextual understanding beyond raw sensor measurements. Methods: We constructed a heterogeneous knowledge graph using multimodal Fitbit physiological signals and affective self-report data collected from 45 users. Framing mood prediction and emotion detection was formulated as both binary and ternary node classification tasks. We evaluated five baseline heterogeneous Graph Neural Network (GNN) architectures and compared them with the proposed Semantically Gated Augmented Graph Neural Network (SeGA-GNN) framework, which dynamically integrates LLM-generated semantic embeddings into graph representations through a gated cross-modal fusion mechanism. Results: The baseline GNN models achieved strong performance, with classification accuracies ranging from 0.7525 to 0.9739 for binary classification and 0.6249 to 0.9699 for ternary classification. The proposed SeGA framework consistently improved predictive performance across most architectures. In particular, semantic augmentation transformed the HAN model from moderate baseline performance into near-perfect emotion recognition capability, achieving SeGA-HAN Accuracy = 0.9988 and AUC = 1.0000 for binary classification and Accuracy = 0.9979 and AUC = 1.0000 for ternary classification. Discussion and Conclusion: Integrating LLM-derived semantic contextualization into heterogeneous graph learning enables effective modeling of contextual information that is not directly captured by wearable physiological signals alone. The proposed SeGA-GNN framework demonstrates that adaptive semantic fusion substantially improves the accuracy, robustness, and interpretability of wearable-based emotion detection. These findings establish a promising direction for next-generation wearable affective computing systems and intelligent emotion-aware applications.

Brain tumor detection using Magnetic Resonance Imaging (MRI) remains a challenging task due to tumor heterogeneity and imaging variability. This paper presents a novel hybrid Deep Convolutional Neural Network-Whale Optimization Algorithm (DCNN-WOA) framework for automated brain tumor detection and classification. The proposed method consists of four main stages: MRI data preprocessing and augmentation, deep feature extraction using multi-layer Convolutional Neural Networks (CNN), feature selection and hyperparameter optimization via the Whale Optimization Algorithm (WOA), and final classification with comprehensive performance evaluation. By jointly optimizing deep features and training parameters, the framework effectively reduces feature redundancy, accelerates convergence, and enhances model generalization. Experimental results on a publicly available MRI dataset demonstrate that the DCNN-WOA model outperforms conventional CNN and state-of-the-art Deep Learning (DL) architectures, achieving an accuracy of 97.8%, sensitivity of 96.4%, specificity of 98.1%, and F1-score of 97.2%. The practical impact of this approach makes it a promising solution for real-time clinical decision-support systems in neuroimaging.

Mental health challenges among university students have increased due to academic pressure, lifestyle changes, and continuous digital engagement. Existing approaches for mental health assessment often rely either on self-reported psychological scales or isolated behavioral indicators, limiting their ability to capture complex temporal and contextual patterns. This study proposes an interpretable multimodal framework for student mental health risk assessment using behavioral sensing, academic information, ecological momentary assessments (EMA), and psychometric survey data. A bidirectional Long Short-Term Memory autoencoder is employed to learn latent temporal representations from day-level behavioral sequences, while graph embeddings capture structural relationships among students using similarity-based neighborhood graphs. These representations are fused with academic and survey-derived features and reduced using Principal Component Analysis and Uniform Manifold Approximation and Projection. K-means clustering is then applied to identify behaviorally distinct student groups. Experimental analysis on the StudentLife dataset demonstrates meaningful clustering performance with a Silhouette Score of 0.4209 and Adjusted Rand Index stability of 0.6869. The identified clusters correspond to low-risk, moderate-risk, and high-risk behavioral profiles. To improve interpretability and practical usability, a fuzzy inference system is introduced to compute mental risk, academic risk, and wellbeing indices using psychometric indicators including PHQ-9, PSS, PANAS, VR-12, and Big Five personality traits. The results demonstrate the potential of combining multimodal behavioral modeling with interpretable fuzzy reasoning to support early mental health risk assessment in educational settings.

Monitoring activities of daily living (ADLs) in the home is a promising approach for tracking dementia progression in older adults. While ambient sensor-based ADL systems are well-studied, most existing ADL recognition systems rely on globally trained models that ignore the spatial organization of in-home activities. In real deployments, where training data are sparse and highly home-specific, global transformer models may fail to capture room-dependent behavioral structure. We propose a deterministic Mixture of Experts (MoE) architecture for in-home ADL recognition, in which each expert is a compact transformer specialized to one room of the home (bedroom, kitchen, bathroom, living area). Input segments are routed using a deterministic gating strategy based on room-level motion activity and time-of-day priors for sleep-related behaviors. Unlike learned routing networks, the proposed gate encodes domain knowledge about where ADLs are likely to occur, reducing model complexity under limited per-home training data. By decomposing ADL recognition into room-specific activity spaces, the proposed architecture reduces competition between dominant and low-frequency activities under highly imbalanced residential data. We evaluated the system on data collected via low-cost ambient sensors (motion, light, temperature, humidity) and Raspberry Pi edge devices across five homes, with ground-truth ADL labels provided by participants and caregivers. Across the five homes, the proposed MoE consistently outperformed global transformer, 1D CNN, and Random Forest baselines, achieving macro-F1 scores ranging from 0.60 to 0.88, highlighting the importance of home-specific modeling in real-world deployments. These findings suggest that room-aware expert specialization may provide a practical and interpretable strategy for low-data ADL recognition in real-world residential environments.

High bit-depth medical images preserve subtle intensity variations that are important for quantitative analysis and clinical interpretation, but their large dynamic range poses challenges for efficient compression. We propose a bit-plane-aware dual-stream compression framework for 16-bit medical images by separately modeling the most significant bit (MSB) and least significant bit (LSB) components. The MSB structural stream is encoded using JPEG coding with a Duplicate Segment Skipping (DSS) strategy to exploit spatial and segment-level redundancy, while the LSB detail stream is compressed using learned image compression to represent residual variations and fine-grained details. Experiments on four MRI and CT datasets show that the proposed method consistently outperforms representative traditional and learning-based codecs, achieving the lowest bit rate across all datasets. Meanwhile, it preserves high reconstruction fidelity. As a downstream application, we further demonstrate that the compressed bitstreams can be effectively integrated with DNA encoding and converted into sequences with favorable biochemical properties.

Introduction: Actigraphy sleep-wake classification methods increasingly seek to leverage raw acceleration data and machine-learning-based classification, but performance evaluation in pediatrics is limited. We trained machine-learning models using pediatric data and compared their sleep-wake classification performance with existing algorithms for children. Methods: Sixty-five children (46% female, ages 5.3 to 17.7 years) completed in-lab overnight polysomnography and wore a GENEActiv device on their non-dominant wrist. The acceleration data were converted into 30-second epochs and aligned with physician-scored sleep-wake data from electroencephalography. Seven machine-learning models were trained using leave-one-subject-out cross-validation. Epoch-by-epoch analyses generated performance metrics (e.g., balanced accuracy [BA]) and discrepancy analyses provided overall sleep duration bias estimates. The combination of highest performance and least bias was used to rank using Euclidean distance scores - where a lower score represents closer to perfect performance and zero bias. For benchmarking, we included GGIR sleep scoring algorithms and an adult trained random forest classifier. Results: Overall, 560.1 hours of polysomnography and actigraphy data were collected (74.4% of epochs were scored as sleep). The pediatric-trained local-global long-short term memory (LSTM) classifier had the most optimal epoch-by-epoch performance (e.g., BA=0.85, sensitivity=0.88, specificity=0.83, ROC-AUC=0.95, and Cohen kappa=0.67). These metrics exceeded that of an adult-trained random forest classifier and GGIR-based algorithms. Discrepancy analyses revealed that overall sleep duration was underestimated by an average of 25 minutes using the LSTM classifier with no proportional bias. Conclusion: We trained seven pediatric sleep-wake classifiers that had strong ability to detect sleep and wake, with the LSTM classifier being most optimal.

Migraine detection and sentiment analysis in healthcare have become increasingly important, particularly with the rise of social media platforms like Twitter, where users often share their personal health experiences. This study presents MASHA (Multi-Agent System for Healthcare Sentiment Analysis), an artificial intelligence (AI)-driven framework that integrates multiple machine learning (ML) models for sentiment analysis of Arabic tweets related to migraines. The system leverages a multi-agent architecture to handle tasks such as data acquisition, pre-processing, model training and real-time decision-making. Key ML models, including Support Vector Machines (SVM), Naive Bayes (NB) and Logistic Regression (LR), are integrated using ensemble techniques, leading to improved classification performance. Experiments conducted on a dataset of Arabic tweets demonstrate that MASHA outperforms traditional methods, achieving an accuracy of 90.0% and an F1-score of 89.46%. Moreover, the system's scalability and flexibility make it suitable for real-time public health monitoring, offering valuable insights into patient experiences and public sentiment regarding healthcare services. MASHA's adaptability suggests its potential application for analysing other healthcare-related conditions, reinforcing the system's scalability and broader relevance. Future work will focus on incorporating deep learning (DL) models and expanding the dataset with content from additional social media platform.

Background and ObjectiveNormative modeling is a key tool for understanding brain alterations in neurodegenerative diseases, such as cerebellar-type multiple system atrophy. However, existing methods lack interpretability and fail to capture clinically meaningful pathological changes. This study presents DINMC, a Deep Interpretable Normative Model Construction framework, which combines autoencoder-based learning with statistical hypothesis testing to better capture and interpret disease-specific neu-roanatomical changes. MethodsThe DINMC framework constructs normative models using neuroimaging data from multi-site large healthy cohorts. It utilizes a U-shaped convolutional autoencoder to train these models, which are then applied to reconstruct brain features from both patients and healthy controls within the same study cohort. Pathological confidence values are derived by fusing original and deviation feature spaces, offering a measure of disease-related pathology reflected in each dimension of the features. The framework was validated through statistical analysis and prognostic classification and regression tasks. ResultsThe pathological confidence provides valuable insights into the neuroanatomical regions most affected by the disease, as well as the correlation between changes in these regions and clinical assessment scales. Our optimal model outperform traditional methods in prognostic prediction tasks, with an AUC of 0.972 for classification tasks and an R2 of 0.432 for regression tasks. ConclusionDINMC provides a novel and interpretable framework for neuroimaging analysis. By combining deep learning and statistical hypothesis testing, this framework offers a unique solution to improving both the interpretability and performance of normative models in neuroimaging. The approach is scalable to other neuroimaging datasets, offering a versatile tool for broader biomedical applications.

Machine learning (ML) is being considered to help diagnose cardiovascular diseases (CVD). Still, challenges like inconsistent and limited datasets, limited infrastructure, and global inequalities lead to the need for a reliable and practicable ML solution. This paper presents an ML-driven framework for predicting CVD risk scores and classifying status. Several data preprocessing techniques, including multiple imputation by chained equations (MICE), outlier removal, are considered. In addition, hyperparameter tuning is performed with the GridSearchCV tuning technique. Moreover, a consensus-driven five-feature selection method is applied to identify optimal predictors. The dataset used in this study contains healthcare records related to future CVD risk scores, comprising 1,529 patient records with 22 features. The optimized stacked ensemble model is applied to the dataset and achieves a cross-validated coefficient of determination value of 98.13% for CVD risk score regression. Comparative evaluation with other ML models confirmed improved accuracy, efficiency, and interpretability. The explainable AI technique SHAP is applied to interpret predictions and highlight key risk factors. Moreover, a deployment-ready web platform with multi-role access has been developed that demonstrates clinical applicability. The proposed framework offers a reliable and interpretable tool for early detection of CVD and personalized risk assessment. In the future, this work can be extended to integrate longitudinal data, medical imaging, and deep learning to improve generalizability and strengthen real-world impact.

Extracting stable subject-specific features from EEG signals remains challenging due to their entanglement with transient brain states. We propose a universal neural framework that disentangles subject-specific features from state-dependent components in raw EEG signals. Our approach employs a disentanglement module with a cross-reconstruction objective to isolate subject-specific representations. We validate our framework on EEG-based biometric recognition using two public datasets with leave-one-state-out cross-validation. Results demonstrate significant improvements in out-of-distribution identification accuracy across four different backbone models, confirming our methods universality and plug-and-play capability. This work advances reliable extraction of neural signatures for personalized neurotechnology applications.

Skin cancer requires early detection for improved survival rates. Most existing methods rely on deep learning based image classification, which is affected by visual similarity among lesions. Fewer studies use Gene Expression (GE) analysis, which captures molecular characteristics but lacks structural and visual details. To overcome limitations of individual modalities, this paper proposes a multimodal framework integrating dermoscopic images and GE profiles for skin cancer classification. EfficientNet and logistic regression are used for image based analysis and genomic skin lesion profiling, respectively, followed by fuzzy rule based decision systems to reduce uncertainty within individual modalities. Finally, fuzzy fusion combines predictions from both modalities using uncertainty based weighting of classifier outputs. The experimental findings show that both the image based and GE based classification models individually achieved accuracies of nearly 92%. However, the integration of prediction results through the proposed fuzzy fusion strategy further enhanced the classification performance, achieving an overall accuracy of 94.25%. The results obtained outperform contemporary methods, highlighting the effectiveness of combining complementary multimodal information compared with single modality approaches.

Reconstructing speech envelopes from electroen-cephalography (EEG) signals is a challenging but valuable task for brain-computer interfaces (BCIs), with applications in assistive communication for individuals with speech impairments. While deep learning has improved reconstruction accuracy, most existing approaches are restricted to single-layer architectures such as convolutional neural networks (CNNs). This limits their ability to capture the full complexity of spatio-temporal and structural EEG patterns. In this work, we systematically extend the VLAAI framework by evaluating 26 architectures that integrate CNNs, long short-term memory networks (LSTMs), and graph convolutional networks (GCNs) in both single-layer and hybrid configurations. Experiments on the 64-channel Spar-rKULee dataset demonstrate that CNNs remain the strongest standalone models, but hybrid designs--particularly CNN-LSTM and CNN-GCN-LSTM--achieve competitive or superior performance. These results highlight the importance of combining spatial, temporal, and graph-based processing, and provide practical guidelines for hybrid architecture design. Our study offers the first large-scale comparative analysis of hybrid models for EEG-based speech envelope reconstruction, advancing robust BCI systems for non-invasive speech decoding.

Subjective auditory-perceptual evaluation and uninterpretable deep learning models limit the clinical assessment of voice disorders. This study proposes a two-phase zero-shot framework to evaluate voice pathology. First, an Audio Spectrogram Transformer is fine-tuned on the Perceptual Voice Quality Database to generate an acoustic latent space. Second, Orthogonal Procrustes analysis maps these acoustic embeddings directly onto the semantic space of a pre-trained Sentence Transformer. The geometric alignment produced continuous semantic axes that outperformed a supervised machine learning baseline in regressing clinician-rated GRBAS (Grade, Roughness, Breathiness, Asthenia, and Strain) severity scales. Furthermore, these axes correlate with traditional acoustic measures, including Harmonics-to-Noise Ratio and local jitter, while remaining robust when applied to aperiodic signals by not requiring fundamental frequency extraction. Most importantly, the model achieved zero-shot semantic expansion, successfully evaluating voices using an untrained, natural clinical vocabulary beyond the GRBAS scale. External validation on the Voice ICarus Database confirmed cross-corpus stability and demonstrated the capacity for zero-shot differential phenotyping of specific etiologies, such as hypokinetic dysphonia and reflux laryngitis. By bridging acoustic and semantic latent spaces, this framework offers an objective, continuous, and transparent metric for evaluating voice quality using voice descriptive vocabulary.

Background Continuous health monitoring enables early detection of diseases and improves therapeutic outcomes. Non-intrusive biosignal sensors, such as capacitive ECG (cECG), offer a practical solution for daily monitoring in private environments, such as smart homes and vehicles. However, artifacts reduce signal quality and compromise reliability. Methods Following a registered report protocol (Warnecke JM et al. Plos One. 2021; 16(7):e0254780), we record data of 44 subjects and develop an artifact index for cECG. We use three signal quality indices (SQIs): the correlation of QRS complexes (corSQI), the R-peak detection consistency (bSQI) and the absolute amplitude ratio (aSQI). Our index classifies overlapping 10s segments with a step-width of 2s into clean or artifact segments. We label a 2s interval as artifacts if all five overlapping segments indicate artifacts. We record cECGs using an armchair with integrated electrodes in a single-arm study involving 44 subjects performing two activities -- reading and watching television (TV); for 11 minutes each. We record a time-synchronized reference ECG with skin electrodes on the chest. To evaluate the artifact index, we compare it with manually generated ground truth. Moreover, we evaluate the clothing materials cotton, linen, jeans, and polyester in 5 subjects. Results Watching TV results in longer, continuously clean signal durations than reading. On average, 88.3% of the signal has a minimum continuous clean duration of 10s, versus 79.8% during reading. All clothing configurations achieve a clean signal duration exceeding 10s. Among the SQI metrics, bSQI performs best, achieving an accuracy of 90.7% and an F1 score of 79.9%. Combining the three SQI metrics in a voting approach improves accuracy to 92.0% and F1 score to 82.1%. Discussion Our artifact index automatically distinguishes clean from artifact cECG segments, promoting health monitoring in unsupervised real-world settings, earlier disease detection, and preventive health management. A limitation is the investigation of only two scenarios (reading and watching TV).

Automated electroencephalography (EEG) seizure detection systems support clinical monitoring through alarm-driven workflows, in which the practical utility of a detector is determined by its event-level false-alarm rate. We examine the false-alarm structure produced by a strong window-level seizure detector on the Temple University Hospital Seizure Corpus (TUSZ) v2.0.6 and find that the false-alarm burden is unevenly distributed across subjects, with worst-decile subjects carrying substantially higher FA/24h than the cohort median. We propose ALARM-Net (Alarm-Level Adaptive Rejection Module), a detector-agnostic event-level alarm-suppression framework. ALARM-Net treats the window-level detector as a frozen black box, generates high-recall event proposals from its per-second probability timeline, and applies a regularized CatBoost classifier over 14 causal features summarizing each proposal's probability morphology, local pre-context, and alarm history. Operating-point selection is governed by predefined clinical constraints on the dev split (strict sensitivity loss [≤] 8 percentage points; FA/24h relative reduction [≥] 30%); the locked operating point is applied without modification to the held-out eval split. ALARM-Net reduces false alarms per 24 hours from 30.75 to 12.63 on dev (a 58.9% reduction) and from 19.43 to 4.60 on eval (a 76.3% reduction), with strict sensitivity loss of 7.5 and 7.8 percentage points respectively. The detector-only false-alarm burden is heavily concentrated on a small subset of subjects (worst-decile mean: 79.55 FA/24h on dev, 52.77 on eval), motivating the event-level suppression approach. Ablations across feature design, suppressor family, and rule-based baselines suggest that event-level reformulation and proposal morphology features, rather than the classifier family alone, drive the observed false-alarm reduction. ALARM-Net complements window-level seizure detectors and highlights the importance of event-level evaluation for clinically oriented seizure detection.

The Empatica E4 wristband provides continuous multi-modal physiological monitoring including blood volume pulse (BVP), electrodermal activity (EDA) and skin temperature (TEMP) but its validity for sleep-stage-specific autonomic and thermoregulatory monitoring has not been systematically evaluated against concurrent polysomnography (PSG). Using the Wearanize+ dataset which provides synchronised PSG, Empatica E4, and Zmax EEG recordings from 100 home-recorded participants; a systematic validation of Empatica E4 physiological signals against PSG ground truth across five sleep stages was conducted. Of 100 participants, 92 had Empatica data; 69 met Zmax EEG signal quality criteria and formed the analysis sample. Heart rate (HR) from the pre-computed Empatica HR channel showed valid stage-specific patterns (Wake: 70.9 bpm, N3: 61.2 bpm) and moderate inter-device MeanNN correspondence with PSG ECG (Spearman r=0.35-0.42 across stages). Skin temperature showed the expected thermoregulatory pattern (Wake: 33.92C, N3: 35.48C) and is recommended for downstream analyses. Tonic EDA showed an inverted stage pattern attributable to wrist sweat accumulation during deep sleep, representing a known confound for wrist-worn EDA during sleep. Phasic EDA showed plausible patterns and may be used with caution. These findings establish a validated feature set for Empatica E4 sleep research and directly inform multimodal psychiatric biomarker studies using the Wearanize+ dataset.

Closed-loop deep brain stimulation (cDBS) for Parkinsons disease requires control strategies that tolerate noisy sensing, patient-specific stimulation responses, medication-related fluctuations, and embedded hardware constraints. We developed a patient-calibrated minute-scale dynamical model of subthalamic beta activity and an embedded explicit trend-zone predictive controller, eTZPC. The model combined a basal-ganglia mechanistic prior with stimulation-amplitude and medication-cycle recordings from five patients, and incorporated individualized stimulation-{beta}STN maps, fast- and slow-timescale stimulation responses, levodopa-related modulation, background drift, and observation noise. eTZPC was designed to maintain {beta}STN activity within a patient-specific target zone under stimulation-amplitude, step-size, and quantization constraints. Compared with dual-threshold (DT) and proportional-integral-derivative (PID) controllers across four disturbance scenarios, eTZPC achieved target-zone regulation close to PID while reducing stimulation-switching burden toward the low-switching profile of DT. Ablation analyses identified distinct contributions of smoothing, trend prediction, patient-specific action modeling, and embedded explicit implementation. Parameter-mismatch tests showed that eTZPC was relatively robust to dynamic and disturbance-parameter deviations, but remained sensitive to errors in the steady-state stimulation-{beta}STN map. Patient-in-the-loop recordings in five patients further confirmed execution consistency and compliance with stimulation-boundary and step-size constraints. These findings support patient-calibrated dynamical modeling combined with low-complexity explicit control as a feasible framework for further embedded cDBS evaluation.

Spousal caregivers of individuals with Alzheimers disease and related dementias frequently experience elevated perceived stress, caregiver burden, and loneliness, which are associated with adverse health outcomes. Early identification is therefore critical for timely intervention. Existing approaches commonly rely on wearable sensor data and standardized psychological questionnaires, while recent multimodal methods aim to improve prediction by integrating behavioral and linguistic information. In this study, we explored three modality configurations, wearable-derived features, interview-based text, and their combination, to classify caregiver psychological risk using the Perceived Stress Scale (PSS), Zarit Burden Interview, and UCLA Loneliness Scale. We compared traditional machine learning models and large language models (LLMs) (Gemini 2.0, Llama 4, and GPT-4o) under psychometrician-centered and caregiver-centered prompting strategies. Traditional machine learning models performed better under multimodal settings, while LLMs achieved stronger performance with Interview-Only input. We further demonstrate that PSS was the most predictable construct and prompting strategies substantially influenced LLM performance.

Non-invasive wrist pulse monitoring has been integrated into various medical systems for cardiovascular assessment. However, different definitions of pulse transit time are used in the literature, and their statistical behavior when measured locally at the wrist using pressure sensors has not been systematically examined. Wearable wristbands designed to measure pulse transit time (PTT) have emerged as valuable tools for evaluating cardiac activity. While several algorithms have been developed to predict blood pressure using PTT, it is well recognized that PTT and its inverse parameter, pulse wave velocity (PWV), exhibit temporal variability. In this study, PTT was explicitly measured at the wrist's radial artery to investigate its statistical variation and relationship with different arterial pressures. The experiment exhibits two distinct methodologies for PTT computation using onset-based and peak based measurements. Data were recorded across five cuff pressure levels at 20, 40, 60, 80, and 100 mmHg using the pulse pressure sensor (PPS). PTTonset time shows lower coefficient of variation as compared to PTTpeak time within the 100 mmHg pressure range. The weak correlation coefficient is recorded between PTT values. However, dynamic time warping (DTW) analysis revealed a notable similarity in the time series of PTTonset and PTTpeak, regardless of the applied pressure level. For the multi participant dataset, the mean DTW distances ranged from 0.029 to 0.046 across the tested cuff pressures, illustrating consistent similarity between PTTonset and PTTpeak over time. The objective of this study is to examine the statistical behavior, stability, and temporal similarity of the two commonly used PTT definitions when measured at the radial artery using pressure sensors. Statistical analysis shows consistent differences between the two PTT definitions across participants. PTTonset shows lower variation than PTTpeak. However, PTTpeak requires simpler computation and produces fewer detection errors, while PTTonset provides lower statistical variation.